BACKGROUND: Meicillin-resistant Staphylococcus aureus(MRSA) is a common cause of nosocomial infections worldwide. Identification of strains by molecular typing facilitates epidemiological studies and improves disease control This study was performed to determine the usefulness of mecA-associated hypervariable region(HVR) polymerase chain reaction (PCR) and random amplified polymorphic DNA(RAPD) analysis in the investigation of a nosocomial MRSA infections. METHODS: Methicillin-resistance was identified by NCCLS disk diffusion method using the oxacillin disk. And PCR was done for detection of mecA gene. Antimicrobial susceptibility test, HVR-PCR and RAPD using 3 primers were performed for epidemiological analysis on isolates of MRSA. RESULTS: During the period from 1997 Dec. to 1998 May, 120 strains of S. aureus were isolated from clinical specimens. Among them, 78 strains were MRSA, and 72 strains were mecA positive. The strains of mecA positive MRSA were classified into four types by antibiogram, six genotypes by HVR-PCR, and 29 groups by RAPD using three primers. The combination of HVR genotypes and RAPD analysis showed 43 different types in 72 mecA positive MRSA isolates The five strains which were repeatedly isolated from the same patients showed the same HVR genotypes and RAPD analysis. CONCLUSIONS: Antibiogram, HVR-PCR, and RAPD could classify MRSA isolates into only 4-6 types, respectively, but combination of these methods could improve the typability. And combination of results of RAPD analysis using three primers were better than that using one primer in epidemiological studies of MRSA because of same reasons. It can be concluded that molecular typing of MRSA using HVR-PCR and RAPD assay is useful in epidemiolgical investigation of nosocomial infections caused by MRSA, because of its simplicity and reproducibility.
Cross Infection ; Diffusion ; Epidemiologic Studies ; Genotype ; Humans ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Microbial Sensitivity Tests ; Molecular Typing ; Oxacillin ; Polymerase Chain Reaction ; Staphylococcus

PURPOSE: This study was conducted to analyze the change in the obesity index in girls receiving a gonadotropin-releasing hormone agonist (GnRHa), based on treatment duration, and to aid in nutritional counseling by investigating dietary habits and lifestyle. METHODS: Anthropometric examinations were conducted on 62 girls treated with GnRHa from January 2010 through July 2014. Parents were asked to fill out questionnaires on patient dietary habits and lifestyle. RESULTS: The group taking GnRHa for over 1 year had a higher rate of obesity increase than the group taking GnRHa for less than 1 year, but they had common habits related to obesity, which should be corrected. In addition, 69.2% of the normal weight group taking GnRHa for over 1 year gained weight, and needed more intensive programs, which include physical exercise and nutritional education. Although girls with precocious puberty showed a decrease in the intake of high-calorie foods with nutritional intervention regardless of treatment duration, they still had problems that needed improvement, such as shorter meals and lack of exercise. CONCLUSION: Girls with precocious puberty and their parents should emphasize maintenance of proper body weight, especially when treatment for over 1 year is anticipated. Consistent education in nutrition, ways to increase intensity and duration of physical activity, and the need to slow down mealtimes are important in managing obesity; doctors need to perform regular checkups and provide nutritional counseling.
Body Weight ; Counseling ; Education ; Exercise ; Female* ; Food Habits* ; Gonadotropin-Releasing Hormone ; Humans ; Life Style* ; Meals ; Motor Activity ; Obesity ; Parents ; Puberty, Precocious*

The reliability of emergency ultrasonographic(US) detection of hemoperitoneum and solid organ injury in blunt abdominal trauma was evaluated retrospectively. From October 1,1995 to August 31,1996,90 patients were included in the study. Ultra- sonographic findings showed a sensitivity, specificity, and accuracy of 97.6%, 97.9%, and 98.1%, respectively, in detecting intraabdominal fluid collection. We believe that US in an emergency center is a quick, safe screening method in the evaluation of blunt abdominal trauma. In our department, US has replaced diagnostic peritonaeal lavage(DPL) and computed tomography(CT) as the screening study of first choice.
Emergencies* ; Hemoperitoneum* ; Humans ; Mass Screening ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography*

No abstract available.
Colorectal Neoplasms* ; Fluorouracil* ; Humans ; Interferon-gamma*

Bilateral diaphragmatic paralysis(BDP) is a rare disorder, which can be secondary to spinal cord injury, motor neuron disease, myopathy, noninfectious polyneuropathy, infection, iced saline cardioplegia performed during cardiac surgery, or idiopathic causes. there may be typical presentations such as dyspnea, paradoxical respiratory movement, and hypercapnic respiratory failure. It needs to exclude above secondary causes to consider idiopathic bilateral diaphragmatic paralysis. We report a 51-years-old man who presented with idiopathic bilateral diaphragmatic paralysis combined with acute pancreatitis. We couldnt, find out the association of these two clinical conditions. The patient was improved by mechanical ventilation.
Dyspnea ; Heart Arrest, Induced ; Humans ; Motor Neuron Disease ; Muscular Diseases ; Pancreatitis* ; Polyneuropathies ; Respiration, Artificial ; Respiratory Insufficiency ; Respiratory Paralysis* ; Spinal Cord Injuries ; Thoracic Surgery

OBJECTIVE: The Center for Epidemiological Studies Depression Scale (CES-D) is designed to measure the current level of depressive symptomatology in the general population. However, no review has examined whether the scale is reliable and valid among children and adolescents in Korea. The purpose of this study was to test whether the Korean form of the CES-D is valid in adolescents. METHODS: Data were obtained from 1,884 adolescents attending grades 1–3 in Korean middle schools. Reliability was evaluated by internal consistency (Cronbach’s alpha). Concurrent validity was evaluated by a correlation analysis between the CES-D and other scales. Construct validity was evaluated by exploratory factor and confirmatory factor analyses. RESULTS: The internal consistency coefficient for the entire group was 0.88. The CES-D was positively correlated with scales that measure negative psychological constructs, such as the State Anxiety Inventory for Children, the Korean Social Anxiety Scale for Children and Adolescents, and the Reynold Suicidal Ideation Questionnaire, but it was negatively correlated with scales that measure positive psychological constructs, such as the Korean version of the Rosenberg Self-Esteem Scale and the Connor-Davidson Resilience Scale-2. The CES-D was examined by three-dimensional exploratory factor analysis, and the three-factor structure of the scale explained 53.165% of the total variance. The variance explained by factor I was 24.836%, that explained by factor II was 15.988%, and that explained by factor III was 12.341%. The construct validity of the CES-D was tested by confirmatory factor analysis, and we applied the entire group’s data using a three-factor hierarchical model. The fit index showed a level similar to those of other countries’ adolescent samples. CONCLUSION: The CES-D has high internal consistency and addresses psychological constructs similar to those addressed by other scales. The CES-D showed a three-factor structure in an exploratory factor analysis. The present findings suggest that the CES-D is a useful and reliable tool for measuring depression in Korean adolescents.
Adolescent Psychiatry ; Adolescent ; Anxiety ; Child ; Depression ; Epidemiologic Studies ; Fibrinogen ; Humans ; Korea ; Prothrombin ; Psychometrics ; Suicidal Ideation ; Thromboplastin ; Weights and Measures

No abstract available.
Carotid Arteries* ; Carotid Stenosis* ; Dyskinesias ; Ischemic Attack, Transient*

Jimson weed, also known as Datura stramonium, is a member of the Solanaceae family. Jimson weed was used by American Indians for medicinal and religious purposes. All parts of the Jimson weed plant are poisons, containing the alkaloids atropine, hyoscyamine and scopolamine. So, it is caused by these components to make a anticholinergic toxicity within 6h after ingestion. Initial manifestations include dry mucus membrane, blurred, vision, thirst, difficulty swallowing and speaking, and photophobia, and may be followed by hyperthermia, confusion, agitation, combative behavior, hallucination, urinary retention, seizure and coma. We experienced two patients who developed combative behavior and agitation with pupil dilation caused by Jimson weed. They discharged with improvement after supportive for 2days.
Alkaloids ; Animals ; Atropine ; Coma ; Comb and Wattles ; Datura stramonium* ; Deglutition ; Dihydroergotamine ; Eating* ; Fever ; Hallucinations ; Humans ; Hyoscyamine ; Indians, North American ; Membranes ; Mucus ; Photophobia ; Plants ; Poisons ; Pupil ; Scopolamine Hydrobromide ; Seizures ; Solanaceae ; Thirst ; Urinary Retention

PURPOSE: Verrucous carcinoma is a rare, low-grade and well-differentiated squamous cell carcinoma, representing as a warty tumor. Estimation of the incidence for cutaneous lesions is not available because they are rare. We describe a case of verrucous carcinoma, a rare type, complication of a chronic pressure ulcer of duration more than 15 years. METHODS: A 17-year-old boy presented with a large lesion involving the sacral area, which had been neglected for about 15 years. He had a history of surgical extirpation 2 years ago, but not cured. Examination revealed a cauliflower-like mass arising from an irregularly oval-shaped tumor which was 6.0x4.5cm in size with signs of infection and ulcer. The lesion involved the sacrococcygeal area, spreading to both medial gluteal regions. The perianal skin did not appear to be directly affected. RESULTS: A preoperative punch biopsy revealed a extremely well differentiated verrucous carcinoma. There were positive results in immunohistochemistry in the items of p53, p63, Ki-67. An 'en-bloc' excision of the tumor with the clinically normal surrounding tissue was carried out. Reconstruction was achieved by local regional flap. Histopathological findings of the excised area fully confirmed the preoperative biopsy report. It remained free of recurrence for a period of about 8 months. CONCLUSION: We believe that in patients with buttock involvement, regardless of the extent of such tumors, surgical therapy should be considered as the first-choice of treatment as reconstruction can be performed without excessive impairment for the patient.
Adolescent ; Biopsy ; Buttocks ; Carcinoma, Squamous Cell ; Carcinoma, Verrucous* ; Humans ; Immunohistochemistry ; Incidence ; Male ; Pressure Ulcer* ; Recurrence ; Skin ; Ulcer

PURPOSE: The major aim of this study is to evaluate the pattems of recurrence of breast cancer and to determine risk factom influencing the pattem. MATERIALS AND METHODS: Medical records of 322 female patients who underwent mastectomy from 1989 till 1992 were reviewed. Recurrence pattem and the length of survival after the first relapse of each relapsed patient were identified. Factors influencing the pattem of recurrence and the length of survival after relapse were analyzed using Cox proportional hazards model. RESULTS: Locoregional relapse was identified in the first failure sites of sixteen patients (5-year relapse rate, 5.7%). Risk of locoregional relapse was associated with the number of positive axillary lymph nodes [adjusted Relative Risk (aRR), 31.28 (95% Confidence Interval (CI), 6.81-143.77)]. The 5-year estimates of the first relapse at bone, lung, pleura, liver, and brain were 15.4%, 6.9%, 1.9%, 3.1%, and 0.8%, respectively. The multivariate analysis indicated that distant metastasis was associated with the number of positive axillary lymph nodes [aRR, 3.14 (95% CI, 1.56-6.32)] and with the age of 35 years and younger [aRR, 1.95 (95% CI, 1.01-3.75)]. The statistical association of negative estrogen receptor (ER) with distant relapse was borderline [aRR, 1.89 (95% CI, 0.99-3.61)]. Factors independently affecting the survival of relapsed patients were the pattem of metastasis and the disease-free interval. CONCLUSION: Bone metastasis was the most frequent pattem of first relapse in Korean breast cancer patients. The number of positive axillary lymph nodes, younger age, and negative ER were independent risk factors for distant relapse in Korean female breast cancer patients.
Brain ; Breast Neoplasms* ; Breast* ; Estrogens ; Female* ; Humans ; Liver ; Lung ; Lymph Nodes ; Mastectomy ; Medical Records ; Multivariate Analysis ; Neoplasm Metastasis ; Pleura ; Proportional Hazards Models ; Recurrence* ; Risk Factors